Foot pain

Foot Pain and foot drop from broken femur.

by Rod
(Colorado)

Foot Pain and foot drop from broken femur.

Three weeks ago my wife broke her femur skiing. It was a compound fracture and protruded out her leg. Now she cannot yet raise her foot up. She has pain down from the middle of her shin to the top of her foot.

An x-ray of her ankle and foot shows no injuries. She experiences an intense burning sensation and a numbness on the top surface of her foot. The orthopedist gave her a script for Lyrica which makes her a little more comfortable but she is very miserable. What can we do to make her foot raise up and get rid of the pain?

Dr. Barrie Lewis

Hello Rod,
It's not good news I'm afraid; either the initial injury (most likely) but also possibly the surgical plating has damaged the sciatic nerve that runs down the back of the thigh.

A branch called the deep fibular nerve supplies the anterior tibial muscle, and sensory to the skin. It's the muscle that raises the foot; it sounds like your wife has what's known as a foot drop. Didn't the surgeon explain it?

I think an immediate neurological consult is important.

I hope this contributes.

Dr Barrie Lewis

Pain in lower back and top and outside edge of right foot

by Anita
(Hanceville Al USA)

Pain started in lower back and then my buttock started hurting. I have pain on the top of the right foot. Then the outside edge of that foot started hurting. It almost feels broken. Xrays have been done on my foot with no signs of anything. Can my low back pain cause this pain on the outside of my foot?

Dr. Barrie Lewis

Hello Anita,
Yes, the S1 dermatome supplies the outside of the foot, so a slipped disc at L5/S1 can certainly cause pain as you suggest.

There's an easy way to tell if it's your foot, or a referred pain from your back. Sit in a normal kitchen chair and extend the knee so your good leg is parallel to the ground. Lower the leg, and now extend your right knee.

Is the right leg much tighter than the left? Does it tingle in your foot?

You can put increased stretch on the nerve by following the direction for Slump test. Into the search function in the navigation bar at Chiropractic Help type slump test for sciatica.

Ask a friend to squeeze, stretch, pummel your feet. Is the right foot much more tender and sore. That it would suggest it was a foot problem, probably not connected to the back.

See our lower back exercises in the navigation bar and if it's not improving, then I would suggest you see a professional of your choice. Don't let it become chronic.

Dr Barrie Lewis

Flappy foot

After a weber a fracture to left fibula, healed well and only mild discomfort; walking without aids but my foot flaps down and after walking at a normal pace for about 20 mins.

I get pain across the top of my foot about half way towards my toes and down and towards the outside to my big toe.

Dr. Barrie Lewis

We are talking about two different problems, most likely.

The first is potentially quite serious; the fibular nerve divides into two branches, one superficial and the other deep. They supply different muscles in the lower leg, controlling the movements of the ankle, and also the skin of the top of the foot.

In all likelihood one of these nerves has been injured. You'd better talk to your orthopedist about where healing is likely, and whether any further can be, should be done.

Go to Wikipedia, type in deep fibular nerve, and then images. You'll see how it's located very close to the fibula.

You probably simultaneously had an injury in the foot, or it could be pain from the damaged nerve.

Dr Barrie Lewis

Second degree foot sprain

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2. Ankle sprain treatment >
3. Chiropractic treatment of the foot

Dr. Barrie Lewis

Hello,
I'm assuming the xray showed nothing. Incidentally with xrays it makes little difference whether taken inside to outside or outside to inside. In anatomical language, medial to lateral or lateral to medial.

In all probability your doctor's advice is correct. You might also ice, and keep wriggling it whilst sitting; moving the ankle helps to move the fluid that has built up.

There are two other questions of importance. The first is whether you subluxated a bone in the ankle during the sprain. It would cause sharp pain when you put weight on the foot, most likely.

And the second whether an incipient fracture was missed. Undisplaced fractures are difficult to see in the early stages until it has swollen in the fracture, and because of the overlapping nature of the bones. A scan may be necessary. This is particularly so because of the deformed look.

The rule is, after a week if you feel it's not improving as expected, go back to your doctor and ask for another xray.

Let us know how you get on and what transpires.

Dr Barrie Lewis

Any therapy I can do while my foot is in Air Cast?

by Gaylene
(British Columbia)

Hello,

I fractured my fibula approximately 4 weeks ago playing ice hockey and going feet first into the boards. I have been in an air cast since then. I do take it off, from time to time. However, I know my ligaments have been stretched & pulled because of my accident.

I would like to know if I have to keep my foot absolutely still, or if I can or should move my toes, or foot a little.

I would like to see my chiropractor soon.

Thank you.

Dr. Barrie Lewis

Hello Gaylene,
Stuff happens, but remember that people who exercise as you do have far less dread disease compared to their couch potato compatriots.

The right person to address this question to is the surgeon who put your leg in the air cast.

The answer is likely to be an emphatic yes but let him tell you that; that's why you're in an aircast not a POP.

Dr Barrie Lewis

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